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An Unusual Side Effect of Acyclovir: Junctional Rhythm-Poonam Patel
Co-Authors: Vagharsh Antanesian, MD MPH, Internal Medicine, PGY 3,Norton Community Hospital Norton, VA
Introduction: Acyclovir, an antiviral agent primarily targeting Herpes Simplex Virus (HSV) infections, presents predominantly mild adverse effects such as malaise (10%), gastrointestinal symptoms, and elevated liver function tests (1-10%). However, more severe complications, notably associated with intravenous administration, encompass rare occurrences of acute renal failure, neurological toxicity, and sporadic cases of bradycardia. A review of literature revealed 2 instances linking acyclovir to bradycardia, with no documented reports on junctional rhythm. A phase IV clinical study examining FDA data identified 1,424 individuals encountering side effects from Acyclovir, with only 6 individuals (0.42%) reporting bradycardia, primarily observed in males aged 60 and above using the medication for less than a month. Here we report a rare case of junctional rhythm caused by acyclovir.
References: “Acyclovir Sodium and Bradycardia - A Phase IV Clinical Study of FDA Data.” eHealthMe, www.ehealthme.com/ds/acyclovir....-sodium/bradycardia/ Accessed 5 Nov. 2023.
Gill, Dalvir, et al. “Unusual side effect of acyclovir: Bradycardia.” The American Journal of Emergency Medicine, vol. 35, no. 3, 2017, https://doi.org/10.1016/j.ajem.2016.10.032.
UpToDate, www.uptodate.com/contents/acyclovir-an-overview?search=acyclovir+cardiac+side+effects&source=search_result&selectedTitle=1~150&usage_type=default&display_rank=1. Accessed 5 Nov. 2023.
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